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University of Nebraska State Museum Virtual Field Trip Scholarship Application
To be considered for a University of Nebraska State Museum Virtual Field Trip program scholarship fill out the form below. You will be contacted withing 5-7 business days on the status of your application.

Questions regarding Virtual Field Trip programs or this application can be directed to:
Annie Mumgaard, Virtual Field Trip Coordinator
amumgaard@unl.edu or 402-472-4075

Scholarship funding made possible through generous support from the Roger's Foundation.

Teacher Name
Your answer
Name of School
Your answer
Classroom Grade
Your answer
# of Students
Your answer
School Address
Kits CANNOT be sent to a P.O. Box.
Your answer
School City, State, Zip
Your answer
Teacher Phone Number
This is the contact number a museum educator can reach the teacher during the scheduled virtual field trip program.
Your answer
Teacher E-mail Address
Your answer
School Tech Coordinator Name
Your answer
School Tech Coordinator Phone
Your answer
ESU Distance Learning Coordinator Name
Your answer
ESU Distance Learning Coordinator Phone Number
Your answer
ESU Distance Learning Coordinator E-mail
Your answer
IP Number
Contact your ESU distance learning coordinator for this information. Information is required for scholarship application. Zoom is an acceptable connecting format.
Your answer
Virtual Field Trip
Choose the virtual field trip program you would like to be presented to your class. Scholarships cover the cost of send and return mailing of classroom kits. For more information on classroom kits go to >>museum.unl.edu/virtualfieldtrips
Required
Preferred Dates & Time
Please list three preferred dates and times you wish to schedule the virtual field trip program. A museum educator will work with you to finalize a program time once your application has been reviewed.
Your answer
Description of Need
Please describe your need for a virtual field trip scholarship.
Your answer
How did you hear about this scholarship opportunity
Please list the resource(s) below.
Your answer
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